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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 65 Chapter 24 Long Term Care

If either the client or the other person proves that the funds withdrawn were the sole property of the other person, the withdrawal does not result in a penalty. 24.8.2.J Transfer Penalty The transfer of resources penalty is a period of ineligibility for: • Nursing facility services; and • A level of care in any institution, equivalent to that of nursing facility services. The client may remain eligible for Medicaid, but only services not subject to a penalty are covered. HCBS waiver groups will not continue their Medicaid eligibility during the transfer penalty, but will be evaluated for other coverage groups. The penalty is applied as follows. 24.8.2.J.1 Start of the Penalty The beginning date of each penalty period imposed for any uncompensated transfer of resources is the later of: • The date on which the individual is eligible for and is receiving institutional level of care services that would be covered by Medicaid if not for the imposition of the penalty period; OR • The first day of the month after the month in which assets were transferred and advance notice expires, when the individual receives LTC Medicaid; AND • Which does not occur during any other period of ineligibility due to a transfer of resources penalty. ➢ Penalty for Transfers during the Look-Back Period When resources have been transferred at singular or multiple points during the look-back period, add together the value of all resources transferred, and divide by the average cost to a private-pay patient of nursing facility services. This produces a single penalty period which begins on the earliest date that would otherwise apply if the transfer had been made in a single lump sum.